﻿<script src="~/Views/YYSM/YYBZ.js"></script>

<div class="page__hd">
    <h1 class="page__title">上门服务</h1>
    <p class="page__desc"></p>
</div>

<div class="page__bd page__bd_spacing">
    <div class="weui-cells weui-cells_form">
        <div class="weui-cells__title">请选择地点</div>

        <div class="weui-cell weui-cell_select">
            <div class="weui-cell__bd">
                <select class="weui-select" id="DepartmentId">
                    <option selected="" value="999">派出所</option>
                </select>
            </div>
        </div>

    </div>

    <div class="weui-cells__title">请填写您的资料</div>
    <div class="weui-cells weui-cells_form">
        <div class="weui-cell">
            <div class="weui-cell__hd"><label class="weui-label">姓名</label></div>
            <div class="weui-cell__bd">
                <input id="Name" class="weui-input" type="text" placeholder="请输入您的姓名">
            </div>
        </div>
        <div class="weui-cell">
            <div class="weui-cell__hd"><label class="weui-label">联系方式</label></div>
            <div class="weui-cell__bd">
                <input id="Tel" class="weui-input" type="number" pattern="[0-9]*" placeholder="请输入您的联系电话">
            </div>
        </div>

        <div class="weui-cell">
            <div class="weui-cell__hd"><label class="weui-label">服务类型</label></div>
            <div class="weui-cell__bd">
                <select class="weui-select" id="BZType">
                    <option selected="" value="身份证办理">身份证办理</option>                    
                </select>
            </div>
        </div>

        <div class="weui-cell">
            <div class="weui-cell__hd"><label class="weui-label">上门地址</label></div>
            <div class="weui-cell__bd">
                <input id="Address" class="weui-input" type="text" placeholder="请输入您的地址">
            </div>
        </div>

    </div>

    <div class="weui-cells__title">请填写预约时间</div>
    <div class="weui-cells weui-cells_form">
        <div class="weui-cell">
            <div class="weui-cell__hd"><label for="" class="weui-label">预约时间</label></div>
            <div class="weui-cell__bd">
                <input class="weui-input" type="date" id="YYTime">
            </div>
        </div>
    </div>

    <div class="weui-btn-area" style="text-align:center;">
        <a class="weui-btn weui-btn_mini weui-btn_primary" id="btnSave">确认提交</a>
    </div>
</div>

<!--BEGIN toast-->
<div id="toast" style="display: none;">
    <div class="weui-mask_transparent"></div>
    <div class="weui-toast">
        <i class="weui-icon-success-no-circle weui-icon_toast"></i>
        <p class="weui-toast__content">提交成功</p>
    </div>
</div>
<!--end toast-->
